Provider Demographics
NPI:1851690747
Name:MESMAN, KRISTINE A (PTA)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:A
Last Name:MESMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-0364
Mailing Address - Country:US
Mailing Address - Phone:207-454-2544
Mailing Address - Fax:
Practice Address - Street 1:1620 RIVER RD
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-4220
Practice Address - Country:US
Practice Address - Phone:207-454-4362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
MEPA2511225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant